Serum retinol concentrations in children are affected by food sources of beta-carotene, fat intake, and anthelmintic drug treatment.

Supplementation with carotene-rich fruits may be an effective and sustainable approach to prevent vitamin A deficiency. To test the effectiveness of mango supplementation, 176 Gambian children, aged 2 to 7 y, were randomly assigned to one of four treatments: 75 g of dried mango containing approximately 150 micro g retinol activity equivalents with (MF) or without (M) 5 g of fat, 5 d/wk for 4 mo or 60,000 micro g of vitamin A (A) or placebo (P) capsule at baseline. After 4 mo, plasma beta-carotene was greater in both the M (P < 0.05) and MF (P = 0.07) groups compared with the P group. After controlling for baseline plasma retinol, elevated acute phase proteins and age, plasma retinol concentrations in the A and MF, but not M, groups were higher than in the P group at the end of the study (P < 0.01). Increases in retinol concentrations, however, were small in both groups. These results support the use of dietary supplementation with dried mangoes and a source of fat as one of several concurrent strategies that can be used to help maintain vitamin A status of children in developing countries where there is a severe seasonal shortage of carotenoid-rich foods.

A Randomized, 4-Month Mango and Fat Supplementation Trial Improved Vitamin A Status among Young Gambian Children

The frequency of consumption of six dark green leafy vegetables (DGLV), their vitamin A values, and the relative contribution of these vegetables to vitamin A requirement of pregnant women in Calabar urban was assessed. A total of 101 pregnant women attending clinic at the University of Calabar Teaching Hospital (UCTH), Calabar were covered. Using a food-frequency questionnaire, the consumption pattern of the DGLV was assessed. The study revealed that 100% of the women used the six leafy vegetables chiefly in form of soups and pottages. Ikong ubong (Telfairia occidentalis), Mon-mon ikong (Talinum triangulare) and Afang (Gnetum africanum) were extensively consumed by the women with slight variation in their patterns of consumption, while Inyang afia (Amaranthus hybridus), Atama (Heinsia crinita) and Editan (Lasianthera africana) were less frequently consumed. High Performance Liquid Chromatography (HPLC) analysis showed the following values of vitamin A in μg RE/100g for the vegetables: Ikong ubong 860±0.10, Mon-mon ikong 39±0.04, Inyang afia 853±0.19, Afang 44±0.18, Atama 26±0.04 and Editan 36±0.04. Also, Ikong soup with a vitamin A value of 4759.75±672 μg RE/100g per portion size (200g) made the highest contribution (255 %) to the vitamin A requirement of the pregnant women, while Atama as Abak (Elaeis guinensis pulp puree) soup (portion size: 150g) with a vitamin A value of 214.33±46 μg RE/100g made the least contribution (12%) to vitamin A requirement in the women. The usual dietary habit of pregnant women in Calabar can sustain their vitamin A status because with the only exception of Atama (Abak soup), a portion size of each of the other green vegetables contain higher levels of vitamin A than the required daily intake of the women.

Vitamin A content of southeastern Nigerian vegetable dishes, their consumption pattern and contribution to vitamin a requirement of pregnant women in Calabar urban, Nigeria.

Vitamin A (VA) deficiency remains a serious problem in the world today. Current approaches to preventing or treating VA deficiency, including dietary intervention with provitamin A compounds, rely on the body converting ingested beta-carotene (betaC) to VA. However, it is not known whether betaC that is already in the tissues can be used as a source of VA to prevent deficiency. The objectives of these studies were to determine whether tissue betaC stores are converted to VA when the Mongolian gerbils have low VA status and whether previously fed betaC is retained in the tissues for later conversion to VA. In the first study, gerbils were prefed diets with betaC (20.3 +/- 6.2 nmol/g diet) (+betaC) or without betaC (-betaC), and with VA [2.4 +/- 1.5 nmol/g diet (+betaC diet) or 12.0 +/- 4.2 nmol/g diet (-betaC diet)] for 7 d, and then depleted of both betaC and VA for up to 84 d. On d 0 after the prefeeding period, hepatic betaC stores were 13.3 +/- 9.1 nmol. These stores were significantly lower after 28d of consuming the -VA/-betaC diet (2.16 +/- 1.7 nmol), even though the hepatic VA concentrations did not change. In the second study, the gerbils were prefed a -VA/+betaC diet (74.3 +/- 19. 7 nmol betaC/g diet) for 7 d, and then fed a betaC-free diet either with (7.1 +/- 1.4 nmol/g) or without VA for up to 34 d. Hepatic betaC stores after the 7-d prefeeding period were 38.1 +/- 20.6 nmol, and were significantly higher than after 7d of consuming either a +VA/-betaC (12.4 +/- 10.8 mmol) or -VA/-betaC diet (11.4 +/- 8.0 nmol). The results from both studies suggest that a substantial amount of hepatic betaC is rapidly lost when betaC is eliminated from the diet and therefore is not conserved to meet later VA needs. The presence of VA in the diet (Study 2) did not affect the rate of betaC loss from the serum and tissues. Moreover, no evidence was found that the stored betaC was utilized for VA. The data suggest that there may be two pools of hepatic betaC, one that is lost rapidly and another that is lost more slowly over time, but losses are not affected by VA status.

Tissue Stores of β-Carotene Are Not Conserved for Later Use as a Source of Vitamin A during Compromised Vitamin A Status in Mongolian Gerbils (Meriones unguiculatus)

A 6-month intervention trial was conducted among 542 Filipino children aged 4 to 7 years to determine the effect of vitamin A-fortified coconut cooking oil intake on their vitamin A status and to identify factors that influence this. Children were randomly assigned to the Experimental group, with vitamin A-fortified cooking oil ration; to Control-1 group with unfortified cooking oil ration; and to Control-2 group without cooking oil ration. In all groups, children's serum retinol concentration improved. Relative change in serum retinol concentration was significantly higher among the Experimental group, with one-third of total vitamin A intake coming from vitamin A-fortified cooking oil intake, than in the Control groups, with more than half of intake from other vitamin A-rich foods. Determinants of post-intervention serum retinol concentration included baseline serum retinol concentration, caregiver's education, receipt of high-dose vitamin A capsule, interaction between consumption of vitamin A-fortified cooking oil and of other vitamin A-rich foods, and between households purchasing cooking oil and food expenditure. Intake of vitamin A-fortified cooking oil combined with vitamin A-rich foods was necessary to increase serum retinol concentration. It is recommended to vigorously promote the consumption of vitamin A-fortified cooking oil together with other vitamin A-rich sources to sustain the prevention and control of vitamin A deficiency.

The effect of vitamin A-fortified coconut cooking oil on the serum retinol concentration of Filipino children 4-7 years old.

Vitamin A deficiency is a major public health nutrition problem in India. It is estimated that 12000-15000 preschool children belonging to poor income groups become blind as a result of the deficiency. The most rational way to prevent and control the problem is thus to increase the dietary intake of the vitamin. The authors evaluated the efficacy of a dietary intervention program to control vitamin A deficiency through inexpensive locally available sources of beta-carotene in 121 7-12 year olds. Subjects were randomly divided into experimental and control groups with a three-day food intake recorded for each subject using a 24-hour recall method and repeated at the end of the study on a randomly selected subsample. No significant difference was observed in the dietary intakes of the groups before the study. Carrots papayas coriander and mint were offered daily over a one-month period as sources of beta-carotene. The serum vitamin A levels of only 114 subjects could be estimated using guidelines of the Interdepartmental Committee on Nutrition for National Defense. Serum vitamin A values of the experimental subjects were significantly higher than those of the controls after the intervention period; 91% of control subjects and 5% of experimental group subjects had low levels of serum vitamin A compared to 9% of control subjects and 95% of experimental group subjects who had acceptable levels. Results indicate that the consumption of small amounts of inexpensive readily available vegetable sources of beta-carotene could help prevent and control vitamin A deficiency. Nutrition education programs are therefore needed to encourage the consumption of these foods in both homes and schools.

https://journals.sagepub.com/doi/pdf/10.1177/156482659401500101

Dietary intervention to control vitamin A deficiency in seven- to twelve-year-old children.

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Dietary intervention to control vitamin A deficiency in seven- to twelve-year-old children.